The Gospel and Healthcare Provision

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By way of introduction, can I say that the first thing we should do, as we think about healthcare, is to thank God for all that is good in our health services and for all the many Christian people (like those we have just heard) working in the NHS. But this morning I want to deal with THE PROBLEM of the gospel of Christ and today’s public health provision, because if we ignore this problem, I believe, the negative consequences are serious. So let me begin with three comments.

First, the essential problem is a divorce between the gospel and healthcare provision. An English trained doctor is now a Canadian Professor of the History of Science and Medicine. And he specialises in the importance of religious beliefs in the practice of medicine and the development of public policy. He puts the problem like this:

“If you want to elicit a startled response from a group of physicians, try asking the following questions: ‘Those of you with more than thirty years of medical practice, think back to the beginning of your practice. What proportion of your patients came to you because of what might be described as an act of God or nature, such as an ordinary bacterial infection? What proportion came to you with a disease for which they were responsible?’ The usual answer will be that 70 percent of all patients came as a result of acts of God or nature and 30 percent were themselves, at least in part, responsible for their ill health. The next question is obvious: ‘What about the situation today?’ The ratio is completely reversed, or worse in the inner cities. Now to the next question: ‘If you are sick and suffering and those you say you love are also suffering with you because of your actions, what can you not avoid knowing and feeling?’ Most physicians are reluctant to think about this, but even the most recalcitrant among us will eventually mutter, ‘guilt’. In the whole of human history, [our Professor, John Patrick, continues] guilt has been a troubling existential reality, and the only solutions that have worked involve words like atonement, sacrifice, repentance, restitution, grace, mercy, and justice. Yet none of these words merits a place in the index of our textbooks. Instead we spend millions on antidepressants, tranquilizers, self-help books, alternative medicine, meditation, and sundry other placebos – everything except existential truth.”

Well, in that interrogative form you have the problem of this divorce or separation of the gospel and healthcare provision. So you now have health services in the West that are providing more effective, more technologically advanced and more pain free treatment than ever before. At the same time, the spiritual pain that is behind so many quasi-medical problems is, I quote, “like the unseen mass of an iceberg, out of sight.” But the problem is compounded by the fact that the gospel has not only been ignored, in today’s healthcare provision.

Secondly, also now, more and more Christian medical personnel are being discriminated against. For they are being forbidden to address the problem. And they are being forbidden in some places not only to impose Christian answers (which they have never wanted to do, as being quite wrong). But they are being forbidden even to propose or advise moral behaviour and lifestyles that (we now know scientifically) will prevent straight illnesses! The case of Dr Richard Scott is just one recent high-profiled example.

And the third aspect of the problem is this. We are facing real madness in terms of the economic consequences. It is an undeniable fact that healthcare costs differ according to lifestyle choices. Studies show that churchgoing, on average, means better health outcomes than non-churchgoing. So, on average, Christians have lower overall lifetime healthcare costs. And, on average, they are better prepared for death. But the majority of Western healthcare governing elites and their bureaucratic managers cannot or will not face these facts. So they do not see their importance for the planning and even survival of their healthcare systems. Worst of all they do not realise that so much of the healthcare budget goes on genital and related issues, for which health services now provide counselling, advice and therapies, some of which undoubtedly cause problems.

Last December Guy Brandon wrote a paper that was published by the Jubilee Centre of Cambridge. The paper was entitled, Free Sex: Who Pays? In it he argues, I quote: “The costs of sexual freedom and relationship breakdown to the taxpayer and wider economy are complex and difficult to calculate, but £100 billion annually is probably a reasonable starting point: about twice as much as alcohol abuse, smoking and obesity combined.” And what Brandon doesn’t say is that £100 billion (in 2011 figures) is £10 billion more than the entire education budget which is £90 billion and only £20 billion less than the entire NHS budget which is £120 billion!

Brandon starts with Iain Duncan Smith’s 2006 study Breakdown Britain where costs per year to the taxpayer for family breakdown were said to be £24 billion (these were upgraded for 2011 as £42 billion directly to the taxpayer). But then Brandon points out there are non-taxpayers’ costs. These, of course, could help fund or reduce national budgets. Three are the following: one, the costs of absenteeism following divorce, that are said to be £20 billion; two, the costs of domestic violence before relationship breakdowns that are said to be £28.4 billion; and, three, the future costs of educational underachievement of children that are said to be £6 billion in terms of reduced GDP. One study has estimated the average impact of divorce on a child is equivalent to half a year of lost education and each year of education averages 8 percent in higher income. Of course, all this is an agenda for more research. But these are vast costs. Even only that £42 billion to the tax payer is the same as the entire Defence budget or the interest on the national debt!

So health providers in the West (for the problem is wider than the UK) are ignoring or rejecting the gospel of Jesus Christ (which is the world’s only answer to the problem of guilt following these lifestyle traumas, with the Cross of Christ offering free forgiveness). And they are ignoring or rejecting the moral law of God (our Maker’s instruction for human flourishing) while at the same time securing legislation to facilitate such rejection. And then people are surprised that the West is bankrupting itself! So how do we seek change?

To help us in our thinking, I want to look now at Luke 10v1-9. And I want to talk about EIGHT PRINCIPLES IN A MISSION FOR CHANGE as we look at this passage. So what can we learn from Luke 10 and Jesus’ sending out of, or his “mission” for, seventy two of his followers? Look at Luke 10v1-9:

“After this the Lord appointed seventy-two others and sent them two by two ahead of him to every town and place where he was about to go. He told them, ‘The harvest is plentiful, but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field. Go! I am sending you out like lambs among wolves. Do not take a purse or bag or sandals; and do not greet anyone on the road. When you enter a house, first say, “Peace to this house.” If a man of peace is there, your peace will rest on him; if not, it will return to you. Stay in that house, eating and drinking whatever they give you, for the worker deserves his wages. Do not move around from house to house. When you enter a town and are welcomed, eat what is set before you. Heal the sick who are there and tell them, “The kingdom of God is near you.”’” (Luke 10v1-9)

Modern day Christian followers of Jesus have quite a lot to learn from this mission. It is certainly relevant to Christian healthcare workers today (and all of us in as we support them), in a new mission to re-inject a Christian ethos and ethic into the NHS. Nor is such a mission a weird proposal. It is facing the reality of what was said prophetically about the health service in an article in the British Medical Journal in 1981: “As the influence of the Church declines until its effect is negligible, as fewer and fewer people are encouraged to, or willing to, take responsibility … a general lowering of standards seems inevitable.”

Now, with regard to our passage, all you need to know by way of background is that it was more of a Gentile mission. And you need to know just two things regarding this Gentile mission. One, Jesus had earlier sent out a mission of the 12 Apostles in a Galilean mission to Jews. But this mission of the 72 was when Jesus was going south towards Judea and so through Samaria. Two, you also need to know that the Assyrians had overrun this Samaritan area centuries earlier and cruelly depopulated it. But to prevent economic collapse they had repopulated it with foreign people. That is the reason for the subsequent hostility between Jews in the south and Samaritans in this northern area. This mission, then, was to non-Jews or Gentiles and, therefore, more relevant for us today. So what are some key principles being laid down that may be of help for now? Let me list eight.

First, there was and always has to be the centrality of Jesus himself and his gospel. These 72 were all followers of Christ. They trusted him and they had learned from him. They knew that he always, in some way, is the answer to solving the fundamental problems of human existence. But they now knew Jesus Christ wanted them to link healing and preaching, as both were vital. It is interesting that the 12 Apostles, as Apostles and working with Jews, were told to preach and, then, heal, in that order (Luke 9v2). The 72 being as (we would say) “laymen” and working with Gentiles (non-Jews) were told to heal and, then, preach, in the reverse order (Luke 10v9).

Be that as it may, certainly down the centuries both caring for the body and caring for the soul have been linked. Certainly the gospel was the foundation on which modern medicine, as the world knows it, was built. Yes, modern medicine is also indebted to pagan Greeks like Hippocrates, and then to Jewish and Arabic medicine. But the Christian tradition has been the most significant. In the early centuries of the Church, from the 4th century onwards (after the time of Constantine), Christians were noted for their belief in Christ but also for two other things. One, they were noted for their universal care for the sick. They looked after not just the wealthy or people easy to treat, but all people. And, two, they were noted for their opposition to the common practice of abortion. They reckoned all life was given by God and equal in value, with all being made in his image. Interestingly, confirmation of the care and compassion, that these early Christians had for the sick and suffering, came from one of their arch-enemies, the neo-pagan Emperor, Julian the Apostate. In a letter of AD 361 he wrote:

“Now we can see what it is that makes these Christians such powerful enemies of our gods. It is the brotherly love which they manifest towards the sick and poor, the thoughtful manner in which they care for the dead and the purity of their own lives.”

He then urged setting up a rival system. Behind a guise of tolerance, he ruthlessly opposed Christians and re-introduced paganism by an ancient version of multi-faithism. But long term the Christian ethic and Christian institutions survived. Julian’s didn’t.

Then jumping the centuries, modern medicine, beginning at the time of the Reformation, was not only based on the ethic of the Ten Commandments and the Golden Rule of the New Testament: “So in everything, do to others what you would have them do to you, for this sums up the Law and the Prophets" (Mt 7v12). It followed the 17th century tradition of men like Thomas Sydenham. He was a great Christian and called “the Father of English Medicine”. This was his advice to someone entering the profession:

“First, that he must one day give an account to the Supreme Judge of all the lives entrusted to his care. Secondly, that all his skill and knowledge and energy, as they have been given him by God, so they should be exercised for his glory and the good of mankind, and not for mere gain or ambition. Thirdly, and not more beautifully than truly, let him reflect that he has undertaken the care of no mean creature, for, in order that he may estimate the value and the greatness of the human race, the only begotten Son of God became himself a man, and thus ennobled it with his divine dignity, and far more than this, died to redeem it. And, fourthly, that the doctor being himself a mortal man, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer.”

The first great principle then, if following the 72, is to have Christ at the centre of all you do and realize that there is an essential link between the gospel and healthcare.

Secondly, there has to be prayer. Look at verse 2:

“Jesus told them, ‘The harvest is plentiful, but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field.’” (Luke 10v2)

These 72 are to pray for “more workers”. How we need more Christian doctors, nurses and other healthcare workers who will not only be trained in apostolic biblical ethics but also be able to hold their own for Christ in the modern pagan medical world. So pray. In the next chapter, Luke records Jesus teaching on prayer. There Jesus says, “Ask and it will be given you” (11v9) – of course, in God’s time and God’s way and assuming your prayer is not utterly selfish or obviously against God’s revealed will. And then Jesus says (11v13): “How much more will your Father in heaven give the Holy Spirit to those who ask him.” So pray for supernatural strength when you are in conflict situations, as you will be today, remembering that promise.

Thirdly, there is the need for an awareness of the reality of being “lambs among wolves”. Look at verse 3:

“Go! [says Jesus] I am sending you out like lambs among wolves.”

There are still people out there like Julian the Apostate. They will be fighting to stop you Christianizing your hospital or clinic or trying to make it more in line with Christian ethics. This happened at the very top to Jeremy Hunt, the Minister of Health, last weekend. He was mildly suggesting the reduction of the abortion limit to 12 weeks. But he was attacked mercilessly by people from what seems now a gruesome and very wrong abortion industry. And they were misrepresenting him. For he was not calling for the repeal of the permission to dispose of babies even up to term, if there is evidence of abnormality, as the media led people to think. He was only proposing this reduction for really healthy babies. And there are other wolves engaged in malicious anti-Christian manipulation to prevent factual research from publication until it is too late for policy decisions. My wife, now retired, but a doctor who specialised in adoption and fostering, seems to have experienced that with regard to homosexual parenting research. All this is why you should, if possible, try to find out someone else to work with for moral support in the attempt to work for change. The 72 went out in pairs. Two are always better than one in such situations.

Fourthly, there is the need for energetic commitment. Look at verse 4:

“Do not take a purse or bag or sandals; and do not greet anyone on the road.” (Luke 10v4)

Jesus was saying, in effect, “don’t take a lot of spare kit; don’t be impolite but there is not time for very long eastern-style greetings.” You need to be in a hurry. Change is needed urgently.

Fifthly, there is the need to seek out responsive people who will soon see the need of a recovery of the Christian faith as it affects medicine. Look at verses 5-6:

“When you enter a house, first say, ‘Peace to this house.’ If a man of peace is there, your peace will rest on him; if not, it will return to you.” (Luke 10v5-6)

Sixthly, distinguish fundamentals from secondary issues.

Never compromise on fundamentals but don’t be rigid over something that is secondary. Look at the first part of verse 7:

“Stay in that house, eating and drinking whatever they give you.”

This may refer to people in this Gentile area providing food that was not strictly kosher, according to Jewish standards. In those situations, Jesus may be suggesting: “don’t ask too many questions; just eat or drink up, for (he goes on) the worker deserves his wages” (and that was what they were getting by way of free hospitality).

Seventhly, don’t be greedy. The last part of verse 7 says:

“Do not move around from house to house.” (v7)

The 72 were not spending their time in trying to discover who would provide the best hospitality. You are not to be working for perks or profits in Christ’s service! So long as expenses are met, be satisfied.

And, finally, and eighth, realise that true healing requires the gospel being preached. This is where we started. Look at verses 8-9:

“When you enter a town and are welcomed, eat what is set before you. Heal the sick who are there and tell them, ‘The kingdom of God is near you.’” (v8-9)

Long term true healing for everyone and for all that 70 percent who we started with, and who have a responsibility for their current condition, needs somehow to be in the context of the truth of the gospel, namely that the risen Lord Jesus Christ is the King of all. And, importantly, he is the king who is the suffering servant through his atoning death on Cross and so can forgive sins. That was where in our place he bore the punishment of our sin, so that your guilt can be atoned for and you are forgiven as you trust in him and then receive, by the Holy Spirit, new life and power. Who this morning needs to realise that? Perhaps you know about some of those lifestyle traumas. And remember no one is too bad to be forgiven or too good not to need to be forgiven.

I must conclude. As your read Luke’s second volume – the Acts of the Apostles – you see there was a division of labour. The 12 apostles decided they had to concentrate on preaching and prayer, while other godly Christians needed to concentrate on practical caring and presumably healing. But both still went together as both were necessary ministries and must not be separated. They were necessary together then; they are still necessary together today. So may God enable us to pray and, as we are able, to work for healthcare provision and the gospel being joined together once again.